UNMC

Membership Registration for Nebraska Physiological Society Meeting

The registration for the meeting includes 2017 membership in the Nebraska Physiological Society, breakfast, lunch and break snacks at the meeting.

DEADLINE: October 2, 2017

* Required information

Name*
Title*
School*
Address*
E-mail*
Phone*

Registration:*

Professional Status Member $50.00
Postdocs and Graduate students $25.00
Undergraduate students $15.00

FRIDAY NIGHT SOCIAL - October 27, 2017
The Friday Night Social will be held at Dudley’s Pizza and Tavern.  2110 S. 67th Street, Omaha, NE - In Aksarben Village. The social will consist of heavy appetizers and two drink tickets (either alcoholic or non-alcoholic).  A bar tab can be started afterwards.  Free parking is available.

Cost for Friday night social:
Free to NPS Members - cost is included in your registration
Guest - $25.00
I will attend the Friday night social Yes No
I will bring a guest to the Friday night social Yes No

See the NPS website for more information.

NOTICE: This Membership Registration Form may be submitted electronically or mailed to the address below. In either case, mail your membership/registration dues to the address below:

Cindy Norton CAP-OM
Executive Director
Nebraska Physiological Society
University of Nebraska Medical Center
Department of Cellular and Integrative Physiology
985850 Nebraska Medical Center
Omaha, NE 68198-5850
Tel:402-559-4426
FAX: 402-559-4438
Email: nps@unmc.edu

Type the text from the image into the space below.

Form last updated 08/14/17

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